ABSTRACT
Despite the increasing volume of evidence demonstrating the efficacy of solar water disinfection (SODIS) as a household water treatment technology, there still appear to be significant barriers to uptake in developing countries. The potential of SODIS is often treated with skepticism in terms of effective treatment, volume, and safety, and is dismissed in preference for more accepted technologies such as ceramic filters and dose chlorination. As part of WATERSPOUTT (EU H2020 688928), our study used a transdisciplinary methodology to cocreate an innovative SODIS system in rural Malawi. The formative work focused on the design of 1) an appropriate and acceptable system and 2) a context-specific intervention delivery program using a behavior-centered design. Initial research identified specific water needs and challenges, which were discussed along with a cocreation process with potential end users, through a series of shared dialogue workshops (SDWs). Specifications from end users outlined a desire for higher volume systems (20 L) that were "familiar" and could be manufactured locally. Development of the "SODIS bucket" was then undertaken by design experts and local manufacturers, with input from end users and subject to controlled testing to ensure efficacy and safety. Concurrent data were collated using questionnaires (n = 777 households), water point mapping (n = 121), water quality testing (n = 46), and behavior change modeling (n = 100 households). These identified specific contextual issues (hydrogeology, water access, gender roles, social capital, and socioeconomic status), and behavioral determinants (normative, ability, and self-regulation factors) that informed the development and delivery mechanism for the implementation toolkit. Integr Environ Assess Manag 2020;16:871-884. © 2020 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC).
Subject(s)
Disinfection , Water Purification , Humans , Malawi , Rural Population , Water , Water Microbiology , Water SupplyABSTRACT
OBJECTIVES: We wished to determine whether early rejection after lung transplantation as assessed by surveillance transbronchial biopsy predicts for survival. METHODS: Between 1990 and 1997, 96 consecutive patients had lung transplantation: 89 had a minimum 1-month follow-up. For 71 consecutive patients we have 1-year follow-up and for 69 patients we have the results of the first 3 biopsies. Cytomegalovirus status, bronchiolitis obliterans prevalence, and use of total lymphoid irradiation are noted. Biopsies were done at 1 week and 1, 3, and 6 months. Standard immunosuppression consisted of induction antilymphocyte globulin and high-dose methylprednisolone induction for 1 week and standard maintenance triple therapy. Acute rejection treatment was with pulse methylprednisolone. Bronchiolitis obliterans syndrome was treated with total lymphoid irradiation and a change to tacrolimus and mycophenolate. Blinded grading using International Society for Heart and Lung Transplantation classification was done retrospectively. RESULTS: Survival at 1 month and 1, 2, and 3 years for the 96-patient cohort with 1-year follow-up was 93%, 74%, 62%, and 56%. Survival was not significantly different for subsets with rejection on any combination of the first 3 biopsies (1/3, 2/3, 3/3) or absence of rejection on the first 3 biopsies. Ninety-one positive biopsy results were graded. Eighteen of 71 patients had one or more moderate or severe rejection episodes without survival difference relative to the others. There was no statistically significant association between acute rejection on the first 3 surveillance biopsy results and bronchiolitis obliterans. CONCLUSIONS: Intensive induction and maintenance immunotherapy with surveillance transbronchial biopsies and aggressive treatment of acute rejection is associated with a survival similar to that of patients without early acute rejection. This regimen appears to uncouple the association between early acute rejection and bronchiolitis obliterans. Further study may elucidate this mechanism.
Subject(s)
Graft Rejection/mortality , Graft Rejection/pathology , Lung Transplantation/pathology , Adolescent , Adult , Aged , Biopsy/statistics & numerical data , Bronchiolitis Obliterans/epidemiology , Bronchiolitis Obliterans/pathology , Bronchoscopy , Cohort Studies , Cytomegalovirus Infections/epidemiology , Female , Humans , Immunosuppressive Agents/therapeutic use , Male , Middle Aged , Predictive Value of Tests , Retrospective Studies , Survival Analysis , Treatment OutcomeSubject(s)
Baths , Baths/history , Baths/trends , History, Ancient , Public Facilities/history , Roman World/history , RomeABSTRACT
The synthesis and alpha-adrenergic activity of a series of substituted 2-imidazolinylindolines are described. Substitution in the indoline ring generated compounds with a spectrum of adrenoceptor antagonist/agonist profiles that proved sensitive to both the nature and position of the substituent. Many of the derivatives possess greater presynaptic antagonist potency than the corresponding benzodioxan 1, dihydrobenzofuran 2, and indan 3 analogues; however, this alpha 2-antagonism is often accompanied by alpha 1-agonist activity. It was not possible to separate alpha 2-antagonist from alpha 1-agonist properties in this series. Compounds of most interest proved to be the N-ethyl 6, 5-chloro-N-methyl 18, and 5-chloro-N-ethyl 23 derivatives, all being potent alpha 2-antagonists and alpha 1-agonists. Substitution at the 4- and 7-position of the indoline ring generally gave compounds with nonselective agonist properties.
Subject(s)
Adrenergic alpha-Agonists/chemical synthesis , Adrenergic alpha-Antagonists/chemical synthesis , Imidazoles/chemical synthesis , Indoles/chemical synthesis , Animals , Binding, Competitive , Chemical Phenomena , Chemistry , Dioxanes/pharmacology , Idazoxan , Imidazoles/pharmacology , In Vitro Techniques , Indoles/pharmacology , Male , Rats , Receptors, Adrenergic, alpha/metabolism , Structure-Activity RelationshipSubject(s)
Antibodies , Animals , Antibody Specificity , Antigens, Neoplasm , Cells, Cultured , Chromium Radioisotopes , Cytotoxicity Tests, Immunologic , Histocompatibility Antigens , Immune Sera , Immunity, Cellular , Immunization , Immunosuppression Therapy , Lymphocytes/immunology , Lymphocytes/radiation effects , Mast-Cell Sarcoma/immunology , Mice , Mice, Inbred A , Mice, Inbred C57BL , Mice, Inbred CBA , Mice, Inbred DBA , Radiation Effects , Solubility , Spleen/cytology , Spleen/radiation effects , Time FactorsSubject(s)
Antigen-Antibody Complex , Immunization, Passive , Lymphocytes/immunology , Animals , Antibody-Producing Cells , Bone Marrow/immunology , Bone Marrow Cells , Centrifugation, Density Gradient , Erythrocytes/immunology , Female , Hemagglutinins/analysis , Hemolysin Proteins/analysis , Hemolytic Plaque Technique , Horses/immunology , Immune Sera , Immunoglobulin Fab Fragments , Immunoglobulin G , Immunosuppression Therapy , Male , Mice , Mice, Inbred C57BL , Mice, Inbred CBA , Pepsin A , Radiation Chimera , Sheep/immunology , Solubility , Spleen/cytology , Thymus Gland/cytologyABSTRACT
Major quantitative, but not qualitative, differences in the various species of proteins in purified membranes from Streptococcus pyogenes and its stabilized L-form have been demonstrated by acidic and alkaline disc gel electrophoresis with and without urea. The fact that no significant differences in the amino acid content or composition between these two membranes could be demonstrated emphasizes that these results are probably due to changes in the relative amounts of the various species of proteins in this subcellular component. The possibility of these protein changes in the L-form membrane being related to its inability to synthesize a rigid cell wall is discussed. Finally, phage-associated lysin, routinely used for removal of the group A streptococcal cell wall, does not appear to affect the protein profile or amino acid composition of the membrane either metabolically or nonmetabolically.